Scribd Logo
Upload

Welcome to Scribd!

  • 237 views

    Nursing Care Plan

    Uploaded by

    Rachelle
    The nursing interventions are aimed at improving the patient's ineffective breathing pattern related to the presence of secretions. The plan includes assessing the patient's respiratory status every 2-4 hours, listening to breath sounds, elevating the head of the bed, encouraging deep breathing exercises and coughing. The expected outcomes after a week are for the patient to maintain their respiratory rate within normal limits, demonstrate techniques to use during dyspneic episodes, and show decreased respiratory effort and an understanding of their condition.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Nursing Care Plan

    Uploaded by

    Rachelle
    237 views2 pages
    The nursing interventions are aimed at improving the patient's ineffective breathing pattern related to the presence of secretions. The plan includes assessing the patient's respiratory status every 2-4 hours, listening to breath sounds, elevating the head of the bed, encouraging deep breathing exercises and coughing. The expected outcomes after a week are for the patient to maintain their respiratory rate within normal limits, demonstrate techniques to use during dyspneic episodes, and show decreased respiratory effort and an understanding of their condition.

    Original Title

    NURSING-CARE-PLAN

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The nursing interventions are aimed at improving the patient's ineffective breathing pattern related to the presence of secretions. The plan includes assessing the patient's respiratory status every 2-4 hours, listening to breath sounds, elevating the head of the bed, encouraging deep breathing exercises and coughing. The expected outcomes after a week are for the patient to maintain their respiratory rate within normal limits, demonstrate techniques to use during dyspneic episodes, and show decreased respiratory effort and an understanding of their condition.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    237 views2 pages

    Nursing Care Plan

    Uploaded by

    Rachelle
    The nursing interventions are aimed at improving the patient's ineffective breathing pattern related to the presence of secretions. The plan includes assessing the patient's respiratory status every 2-4 hours, listening to breath sounds, elevating the head of the bed, encouraging deep breathing exercises and coughing. The expected outcomes after a week are for the patient to maintain their respiratory rate within normal limits, demonstrate techniques to use during dyspneic episodes, and show decreased respiratory effort and an understanding of their condition.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    You are on page 1of 2

    ASSESSMENT/ DIAGNOSIS PLANNING INTERVENTION EVALUATION

    PROBLEM RATIONALE OF THE DESIRED BEHAVIORAL NURSING RATIONALE


    CUES/NRSG. DX PROBLEM OUTCOME(S) OUTCOME(S) INTERVENTIONS
    Subjective Data: Presence of After a week of After 8 hours of Independent: After a week of
    “Inday akong ginhawa secretions in the nursing nursing - Assess patient’s -Manifestation of nursing
    ba kay kuwang bronchi will result into intervention, the intervention the respiratory respiratory distress intervention the
    kuwang ra, lisud e a blockage of air that patient will patient will be status every 2 to include shortness patient was able
    ginhawa sugod pa ni will enter the body maintain a able to maintain: 4 hours as of breath, to maintain
    gahapun” as verbalize and thus producing respiratory rate 1. Demonstrate indicated and Tachypnea, respiratory rate
    by the patient insufficient air needed within normal two breathing notify any changes in mental within normal
    by the body. And limits and techniques to abnormal status and the use range in 20 cpm
    Objective data: inability to maintain demonstrate use during findings. of accessory and
     The patient stops clear airway. This improvement of dyspneic muscles. demonstrate
    and breath again obstruction is further breathing episodes. - Auscultate -Decreased breath improvement of
    every after 2-4 heightened by pattern. breath sounds sounds, crackles, breathing
    words bronchospasm due to 2. Verbalized two every 2 to 4 wheezes, and pattern as
     Dyspnea the contraction of the ways on how to hours as rhonchi can be evidence by
     Wheezing upon muscles in the prevent COPD indicated. observed and must performing
    inspiration and bronchi. This is exacerbation. be reported pursed lip
    expiration caused the promptly for breathing and
     Using of accessory parasympathetic 3. Manifest signs immediate deep breathing
    muscle in breathing stimulation of the of decreased of treatment. exercise.
     Tachypnea and muscarinic2 receptors respiratory - Elevate head of -To minimize
    irregular as well as by chemical effort as the bed and difficulty in
     Coughing sputum is mediators released in evidence by position of the breathing
    yellow and sticky response to the absence of patient every 2
    presence of allergen. dyspnea hours.
     Restlessness
    - Encourage deep
     Cyanosis
    4. Verbalize breathing - To maximize effort
     Oxygen saturation at understanding exercise and for expectoration.
    87% of causative coughing
    Vital Signs factors and exercise
    HR- 113 bpm demonstrate - Demonstrate
    BP- 150/86 mmHg behaviors that diaphragmatic - To decrease air
    RR- 36 cpm would improve and pursed lip trapping and for
    T- 37.5 °C breathing breathing efficient breathing.
    pattern - Encourage
    Nursing Diagnosis:
    Ineffective breathing increase in fluid - To prevent fatigue
    pattern related to 5. Demonstrate intake
    presence of pursed lip - Encourage
    secretions as breathing opportunities for - To prevent
    evidence by exercise and rest and limit situations that still
    productive cough, diaphragmatic physical aggravate the
    dyspnea, and use of breathing activities. condition
    accessory muscle
    Dependent:
    - Administer
    corticosteroids - To help improve
    and patients breathing
    bronchodilator and for treatment
    medicine as
    prescribe by the
    physician

    Collaborative:
    - Refer the client
    to a dietician - For proper
    and or support counselling and
    group intake of caloric
    needs

    You might also like

    pFad - Phonifier reborn

    Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

    Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


    Alternative Proxies:

    Alternative Proxy

    pFad Proxy

    pFad v3 Proxy

    pFad v4 Proxy